1. Academic Validation
  2. First-in-Maintenance Therapy for Localized High-Grade Osteosarcoma: An Open-Label Phase I/II Trial of the Anti-PD-L1 Antibody ZKAB001

First-in-Maintenance Therapy for Localized High-Grade Osteosarcoma: An Open-Label Phase I/II Trial of the Anti-PD-L1 Antibody ZKAB001

  • Clin Cancer Res. 2023 Feb 16;29(4):764-774. doi: 10.1158/1078-0432.CCR-22-2470.
Yan Zhou 1 Qingcheng Yang 2 Yang Dong 2 Tong Ji 3 Bing Zhang 4 Cheng Yang 5 Shuier Zheng 1 Lina Tang 1 Chenliang Zhou 1 Guowei Qian 1 Yujing Huang 1 Wenxi Yu 1 Hongtao Li 1 Yonggang Wang 1 Aina He 1 Zan Shen 1 Qiyuan Bao 6 Yingqi Hua 7 Hongyu Bai 8 Jiayi Zhao 8 Xiaoyi Li 9 Xiangrong Dai 9 Jianjun Zhang 1 10 Haiyan Hu 1 11 Yang Yao 1
Affiliations

Affiliations

  • 1 Oncology Department of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 2 Orthopaedic Department of Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 3 Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 4 Department of Orthopaedic Oncology, the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Jiangxi, China.
  • 5 Department of Orthopaedic Oncology, Changzheng Hospital of Naval Military Medical University, Shanghai, China.
  • 6 Department of Orthopedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  • 7 Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Bone Tumor Institution, Shanghai, China.
  • 8 Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 9 Lee's Pharmaceutical (HK) Limited, Hong Kong Science Park, Shatin, Hong Kong.
  • 10 Department of Oncology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 11 Shanghai Clinical Research Ward (SCRW), Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract

Purpose: We investigated the safety and preliminary efficacy of anti-PD-L1 antibody (ZKAB001) as maintenance therapy for localized patients with high-grade osteosarcoma to reduce the risk of recurrence and metastasis.

Patients and methods: This open-label Phase I/II study was divided into dose-escalation Phase I and expansion Phase II. Phase I used a 3+3 design with ZKAB001 at three escalating doses ranging: 5, 10, 15 mg/kg every 2 weeks in 9 patients with localized high-grade osteosarcoma and Phase II tested 10 mg/kg in 12 patients for up to 24 cycles. Primary endpoints were safety and tolerability assessed using CTCAE4.0.3.

Results: Between October 2018 and 2019, 21 eligible patients were enrolled and accepted ZKAB001 treatment: 9 in the dose-escalation phase, and 12 in expansion phase. Six patients with disease progression withdrew from this study and follow-up is ongoing. The MTD was not defined in Phase I. All doses had a manageable safety profile. The recommended dose in Phase II was set at 10 mg/kg. Most frequent immune-related adverse events were thyroiditis (76.2%) and dermatitis (42.9%). Only 1 (4.8%) of 21 patients had a Grade 3 skin rash. The median 3-year event-free survival (EFS) and overall survival (OS) were not established; however, 24-month EFS was 71.4% (95% confidence interval, 47.2-86.0) and 2-year OS was 100%. Preliminary efficacy data showed EFS benefits in patients with PD-L1 positive or an MSI-H sub-population.

Conclusions: Switching to maintenance using ZKAB001 showed an acceptable safety profile and provided preliminary evidence of clinical activity in localized patients with osteosarcoma.

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